17D2038586 CLIA NUMBER - WALGREENS #2750

Laboratory Demographics

  • CLIA Code: 17D2038586
  • Facility Name: WALGREENS #2750
  • Facility Address: 5555 SOUTH BROADWAY AVE
    WICHITA, KS
    ZIP 67216
  • Facility Phone: 316 529-1788
  • Facility Type: Pharmacy
  • Facility Type: Waiver
  • Lab Director: OLIVIA CHANEY
  • NPI Number: 1679588891
  • Taxonomy: 333600000X - Pharmacy

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CLIA Record

Field Name Field Value
CLIA Number 17D2038586
LAB Type Pharmacy
Facility Name WALGREENS #2750
Street 5555 SOUTH BROADWAY AVE
City WICHITA
State KS
ZIP 67216
Phone 316 529-1788
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 5/24/2025
Certificate Expiration Date 5/23/2027
Facility Type Pharmacy
Lab Director OLIVIA CHANEY

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This page was last updated on: 9/29/2025